Omicron

What is going on, if you missed it (which I hope in some ways you did, so please stop reading if you don’t know what I’m talking about!) is the following. A new COVID variant, B.1.1.529 was detected in South Africa (South Africa has extremely good sequencing technology, which is very likely why they are the ones who found it.) It appears to have spread rapidly there, although the overall number of cases is still small. A few cases have popped up elsewhere (notably in Hong Kong). What is concerning to epidemiologists about the new variant (which the WHO has called Omicron — Nu was next in line but they thought the “New Nu” variant was a bit too on point) is that it has a large number of mutations and many of them are on the spike protein. This is the protein that the virus uses to get into cells, and it’s what is targeted by vaccines. Based on what we know about the virus, the mutations raise concerns about (A) faster spread and (B) possible “vaccine evasion”. This vaccine evasion could occur because our vaccines target the spike protein. If it is very different, vaccines could be less effective. The particular mutations in Omicron are shared with some other earlier variants which showed some vaccine evasion (but didn’t spread well). There is reason for concern based on these mutations but, and I cannot emphasize this enough, we actually do not really know much of anything precise at this point. It will be a few weeks before we know whether the variant evades vaccines and to what extent. It will take time to know if it spreads more quickly, or causes more (or less) severe disease. None of this is at all clear at this point and if people say otherwise, they are wrong. There are a very wide range of possible outcomes. The best case scenario is this is a false alarm, vaccines continue to work, and it’s a red flag that we must improve vaccine coverage globally. The worst case is that this variant is more contagious and shows some vaccine evasion. If this does occur, we see new vaccines within a few months, targeted to Omicron. This scenario would be, frankly, extremely bad. But it’s not a return to February 2020; we know a lot more, vaccines can be produced faster, testing is better, and so on. At this point, we really could be anywhere between these. We just do not know. But, and this is the point of writing today, what is very clear is that there is nothing that you or I can do about this right now other than worry about it. Unless you’re Stephane Bancel, you cannot affect the speed at which we learn more about the variant. There is nothing different to do right now based on its existence. You shouldn’t not send your child back to school Monday. You shouldn’t cancel holiday plans. There is nothing to do. Yes, you can worry. But is there any point in worrying if you cannot change things? I will channel my therapist, Wendy, and say: No. If we can, this may be something we should all try not to think about until we know more. Note: Writing details about viral epidemiology is not the thing I bring most effectively to the table. If you do want to dive more deeply into the science, Katelyn Jetelina has by far the most helpful take I’ve read, over at Your Local Epidemiologist. She comes to the same “wait and see” that I do above, but with much more detailed science.

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